Provider Demographics
NPI:1780692392
Name:OH, WHIE (MD)
Entity type:Individual
Prefix:
First Name:WHIE
Middle Name:
Last Name:OH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 ADAMS ST
Mailing Address - Street 2:STE 102
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1107
Mailing Address - Country:US
Mailing Address - Phone:707-995-5628
Mailing Address - Fax:707-995-0904
Practice Address - Street 1:15250 LAKESHORE DR STE C
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422-8107
Practice Address - Country:US
Practice Address - Phone:707-995-3764
Practice Address - Fax:707-995-0904
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA24693207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A246930Medicaid
CA00A246932Medicare ID - Type UnspecifiedLAKE COUNTY
CA00A246930Medicare ID - Type UnspecifiedNAPA COUNTY